Principles of Disaster Mitigation in Health Facilities - DISASTER info ...

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Principles of Disaster Mitigation in Health Facilities 3. At some point during an emergency or disaster, it may be necessary to evacuate ambulatory and non-ambulatory patients. This will be more complex if the disaster occurs suddenly and at a time when there are many visitors who are generally unfamiliar with evacuation procedures. Throughout Latin America, the number of visitors at peak hours, such as weekends, can be as high as double the number of patients. Photograph 5. Column failure during earthquake. A hospital’s capacity for effective disaster response depends on systematic organization and easy mobilization of personnel, equipment and supplies in a safe environment. Procedures, buildings and equipment are all critical and interdependent. A weakness in any element of a hospital’s functional system could cause a crisis throughout the institution. The following issues must be taken into consideration: Emergency procedures. Emergency procedures are especially important in the mobilization of people, equipment and supplies. The design of the necessary procedures includes the formation of a committee to formulate and implement disaster mitigation measures and carry out emergency response planning. Buildings. Disaster mitigation plans must address the need for repairs in case of damage to the hospital facilities, both before and after a disaster occurs. Past events have demonstrated that existing plans are deficient in this area. The design and construction of hospital buildings must take into account occupants’ safety and the preservation of critical areas including the emergency room, diagnostic services, surgery units, pharmacy, and food and medicine storage areas. 16
Chapter 1 — Disasters and Hospitals In the past, hospital design emphasized optimum use of space and configuration of services so as to provide the most effective interrelation of functions and activities among different departments. Many new hospitals built with modern design and construction techniques have been found lacking when called upon to attend to massive numbers of injured patients. This is often due to defects in the distribution of elements and the location and arrangement of nonstructural components. Many establishments fail due to simple design omissions that could have been corrected at a marginal cost during construction or through later intervention. Photograph 6. Collapse of stairway during earthquake prevents evacuation. Equipment. The items found within a hospital building are more likely to become a hazard during an earthquake than during a hurricane. A great deal of damage can be averted through simple, inexpensive mitigation measures, such as securing shelves to the walls and placing equipment strategically in safe locations. Regular inspections and appropriate maintenance can assure that equipment is kept in good working order. Estimating damage to hospitals after a disaster The assessment of damage sustained by a hospital should be conducted by a multidisciplinary team including doctors, engineers and architects. The team should develop a strategy that will allow hospital activities to continue effectively despite the upheaval caused by the disaster. The assessment strategy will depend on the kind of disaster. In the case of an earthquake that has caused the partial or total collapse of the physical structure, files on the building’s infrastructure, service capacity and the number of people occupying it when the disaster occurred may be destroyed so it may be necessary to gather this information from outside sources. 17
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In a period of only 15 years, betwe
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